Presentation and Management of Uterine Fibroids at the Lagos University Teaching Hospital, Lagos.

Abstract

To review the clinical presentation and management of uterine fibroids at the Lagos University Teaching Hospital, Idi-Araba, Lagos. women with uterine fibroids that presented at the Gynaecological outpatient clinic were followed up till surgery and data on sociodemographic profile, parity, presenting signs and symptoms, uterine size at presentation, associated infertility and modality of surgical management was obtained using a structured form. The mean age was 36.6±7.8years (range 20-55years). There were 219(81.4%) in the reproductive age group between 15-45years and of these, 141(52.6%) were nulliparous. 151(57.8%) presented with menorrhagia, 154(57.5%) had dysmenorrhea, 157(58.7%) presented with abdominal swelling and 101(37.6%) had associated abdominal pains at presentation. One hundred and twenty one (45%) of the women had infertility, with 94(77.7%) being secondary infertility and 27(22.3%) primary infertility. Majority of the women 191(71.3%) had myomectomy for fertility preservation while others had hysterectomy and vaginal polypectomy. Leiomyomata represent the most common gynaecologic tumour in this environment and nulliparity is an important risk factor as seen in this study. Treatment must be individualized based on such considerations as the presence and severity of symptoms, the patient's desire for definitive treatment, the desire to preserve childbearing capacity and the importance of uterine preservation.

Keywords: fibroids, infertility, myomectomy